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Should this be flagged as periodic breathing?
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jen61 Offline

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Posts: 26
Joined: Jun 2016

Machine: DreamStation Auto CPAP
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: Built In
CPAP Pressure: 4-20
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Missouri USA

Post: #1
Should this be flagged as periodic breathing?
I've only had 2 instances of flagged periodic breathing in the past month, but honestly the breathing pattern that was flagged looks more normal than this pattern I noticed last week. This breathing pattern wasn't flagged for periodic breathing. Does this look like anything normal?
[Image: 1HsJlUpl.png]
[Image: g0GYXKCl.png]
[Image: bv0ewU2l.png]

Below are the events flagged as period breathing.
[Image: KyGH2wal.png]
[Image: Yjwm3B0l.png]

What do you all think?
07-15-2016 08:41 PM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #2
RE: Should this be flagged as periodic breathing?
I had something like that, different shape but the same repeating like yours. I don't know enough to comment further, but there are those here that do. Wait for them to come by and comment.
07-15-2016 09:36 PM
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #3
RE: Should this be flagged as periodic breathing?
Hi jen61,

The posted zoomed-in Flow waveforms have mixed obstructive apneas and central apneas marked. Unlike with most users, your obstructive apneas rarely ended with sudden "recovery breaths" but instead end gradually, with the amplitude of the Flow waveform gradually increasing in amplitude, as if Periodic Breathing.

So your Flow waveforms look a lot like central PB, but I think what is missing in your waveforms and would be present in central PB is smooth rounded tops on the inhalations. Instead, the tops usually show signs of Flow Limitation, which indicates partial obstruction of the airway and indicates the pressure during inhalation was too low to adequately open the airway.

Your Min Pressure (4) is set way too low for your present pressure needs.

Your 95 percentile pressures were 20, 20 and 17. This is an average of 19 and is very high. Our 95% pressure is the estimated pressure that our mask was at or below for at least 95% of the time. The 95% pressure is also the estimated pressure the mask was at or above for at least 5% of the time.

I think it is generally advisable for our Min Pressure to be set between 1 to 4 lower than our average 90% or 95% pressure, although a few APAP users have found they do best when their Min Pressure is even closer to their 95% pressure.

I would suggest gradually working your Min Pressure up to around 15 or 16, if your average 95% pressure remains around 19.

I would also suggest requesting your doctor to prescribe an auto-adjusting standard bilevel. Auto BiPAP machines are more adjustable and usually more comfortable than APAP machines when our treatment pressures are higher than 15.

But Obstructive Sleep Apnea is often strongly positional, and perhaps your pressure needs could be greatly reduced by taking precautions which would prevent you from rolling onto your back while asleep.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 07-17-2016 04:49 PM by vsheline.)
07-17-2016 05:27 AM
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jen61 Offline

Preferred Members

Posts: 26
Joined: Jun 2016

Machine: DreamStation Auto CPAP
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: Built In
CPAP Pressure: 4-20
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Missouri USA

Post: #4
RE: Should this be flagged as periodic breathing?
Thanks for helpful info. It's hard for me to figure out the rhyme and reason of all these stats sometimes. I had another night last night of odd breathing patterns, even at pressures of 17-18.
I'm scheduled for an in-lab sleep study soon (vs the home study I did before being diagnosed). The sleep lab tech also mentioned possibly needing a bi-pap machine when I showed her the odd breathing patterns I was having. Since the lab study will be more in depth, hopefully they can come up with a solution soon. It's been almost a month and my numbers are still varying greatly.
07-17-2016 09:46 PM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #5
RE: Should this be flagged as periodic breathing?
I would suggest that you say that you want a BiLevel machine, you don't need an ASV (highest level) and the BiLevel has some nice features that the APAP does not have- you can always just not use them. I have found that the sleep lab tries to give me the machine I want, if for nothing more than to get me off their porch Smile
07-17-2016 11:56 PM
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jen61 Offline

Preferred Members

Posts: 26
Joined: Jun 2016

Machine: DreamStation Auto CPAP
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: Built In
CPAP Pressure: 4-20
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Missouri USA

Post: #6
RE: Should this be flagged as periodic breathing?
(07-17-2016 11:56 PM)PoolQ Wrote:  I have found that the sleep lab tries to give me the machine I want, if for nothing more than to get me off their porch Smile
LOL...Big Grin I don't know much about machines but I will check into that one. Thanks
07-18-2016 09:08 AM
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